Comments on Fungal Susceptibility

2) Fluconazole interpretations are based on extensive experience with mucosal and invasive infections. Doses of fluconazole of 400 mg/day or more may be required in adults with normal renal function and body habitus.

3) Itraconazole interpretive data are based entirely on experience with MUCOSAL infections. Data supporting breakpoints for INVASIVE infections due to Candida species are not available. For itraconazole, measures to assure adequate drug absorption and plasma itraconazole concentrations of >0.5 ug/ml may be required for optimal response.

4) There is no resistant category assigned for echinocandin agents. Isolates with higher MICs may be described as nonsusceptible. These breakpoints are currently considered tentative. For the echinocandin agents anidulafungin, caspofungin, micafungin, and voriconazole, the data are based substantially on experience with non-neutropenic patients with candidemia, and their clinical relevance in other settings is uncertain.

DISCLAIMER: Candida MIC tests are evolving. Clinical correlations are still lacking. This test was developed and its performance characteristics determined by Stanford Clinical Micro/Viro Lab. It has not been cleared or approved by the U.S. Food and Drug Administration. Such approval is not required for tests validated by the performing laboratory. Results for anidulafungin, caspofungin, micafungin, posaconazole, and voriconazole are provided for research use only at this time and have not been validated by our laboratory. Validation is in progress.